Squamous Cell Carcinoma

Squamous Cell Carcinoma: Causes, Symptoms, and Treatment

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Squamous cell carcinoma (SCC) is the second most common type of non-melanoma skin cancer, affecting millions worldwide. It arises from the squamous cells in the epidermis and is primarily caused by prolonged UV radiation exposure. While it is generally less aggressive than melanoma, untreated SCC can metastasize, making early detection and treatment crucial.

This comprehensive guide covers everything you need to know about squamous cell carcinoma, including its symptoms, risk factors, diagnosis, and the latest treatment options such as Mohs surgery and immunotherapy.

Must Check: Skin Cancer Causes

What Is Squamous Cell Carcinoma? (Definition + Basics)

Squamous cell carcinoma (SCC) is a type of skin cancer that develops in the squamous cells—flat, scale-like cells in the outer layer of the skin (epidermis). It commonly appears on sun-exposed areas like the face, ears, neck, hands, and arms but can also occur in other body parts, including the lips, mouth, and genitals.

Key Characteristics of SCC:

  • Slow-growing but potentially invasive if left untreated.

  • Can develop from precancerous lesions like actinic keratosis.

  • More common in older adults with a history of sun exposure.

  • Rare cases may spread (metastasize) to lymph nodes or organs.

Understanding the basics of SCC helps in early identification and effective management.

Signs and Symptoms of Squamous Cell Carcinoma

Recognizing the early warning signs of SCC can lead to prompt treatment and better outcomes. Here are the most common SCC symptoms:

Visual Symptoms:

  • Rough, scaly red patches (may resemble actinic keratosis, a precursor).

  • Open sores that don’t heal or repeatedly bleed.

  • Raised growths with a central depression (crater-like).

  • Wart-like bumps that crust or bleed.

  • Persistent scaly or thickened skin on the lips (actinic cheilitis).

Advanced Symptoms (Indicating Possible Spread):

  • Enlarged lymph nodes near the tumor.

  • Pain, numbness, or tingling in the affected area.

  • Rapid growth of a previously stable lesion.

If you notice any of these changes, consult a dermatologist immediately.

Causes and Risk Factors of Squamous Cell Carcinoma

While UV radiation is the leading cause of SCC, several other factors increase risk:

Primary Causes:

  • Chronic sun exposure (tanning beds, outdoor occupations).

  • History of sunburns, especially in childhood.

  • Weakened immune system (organ transplant patients, HIV).

Additional Risk Factors:

  • Fair skin, light hair, and blue/green eyes (less melanin protection).

  • Exposure to arsenic or industrial chemicals.

  • Long-term skin inflammation (burns, scars, chronic wounds).

  • HPV infection (linked to genital and mucosal SCC).

  • Genetic conditions like xeroderma pigmentosum.

Preventive measures, such as daily sunscreen use and protective clothing, can significantly reduce SCC risk.

Diagnosis and Staging of Squamous Cell Carcinoma

Early diagnosis of SCC improves treatment success. Here’s how doctors confirm and stage the disease:

Diagnostic Methods:

  1. Skin Biopsy (Definitive Test):

    • Shave biopsy (for surface lesions).

    • Punch biopsy (for deeper tissue sampling).

    • Excisional biopsy (removes the entire lesion).

  2. Imaging Tests (If Metastasis Is Suspected):

    • CT scan, MRI, or PET scan to check lymph nodes and organs.

    • Ultrasound for assessing tumor depth.

Staging (TNM System):

The TNM classification evaluates:

  • T (Tumor size/depth)

  • N (Lymph Node involvement)

  • M (Metastasis to distant organs)

Stage Description
0 Carcinoma in situ (pre-cancer).
I Small tumor, no spread.
II Larger/deeper tumor, no spread.
III Spread to nearby lymph nodes.
IV Distant metastasis (lungs, liver).

Accurate staging guides treatment decisions.

Treatment Options for Squamous Cell Carcinoma

Treatment depends on the tumor size, location, and stage. Common SCC treatments include:

1. Surgical Treatments Squamous Cell Carcinoma

  • Excision: Cutting out the tumor with a margin of healthy skin.

  • Mohs Surgery: Highly precise, layer-by-layer removal (best for facial SCC).

  • Curettage & Electrodessication: Scraping away cancer cells, then burning the base.

2. Radiation Therapy Squamous Cell Carcinoma

  • Used for elderly patients or inoperable tumors.

  • Effective for SCC on the nose, eyelids, or ears.

3. Topical Medications Squamous Cell Carcinoma

  • 5-fluorouracil (5-FU) or imiquimod for superficial SCC.

4. Advanced & Metastatic SCC Treatments

  • Immunotherapy (PD-1 inhibitors): Pembrolizumab (Keytruda) or cemiplimab (Libtayo).

  • Chemotherapy: For aggressive, spreading SCC.

  • Targeted Therapy: EGFR inhibitors in recurrent cases.

5. Prevention & Follow-Up

  • Regular skin checks by a dermatologist.

  • Sun protection (SPF 30+, hats, UV-blocking clothing).

  • Monitoring for recurrence (higher risk in immunocompromised patients).

Conclusion

Squamous cell carcinoma (SCC) is a serious but treatable form of non-melanoma skin cancer. Early detection of SCC symptoms, such as non-healing sores or scaly patches, is crucial. UV radiation remains the biggest risk factor, making sun protection essential.

With advanced treatments like Mohs surgery, immunotherapy, and radiation, most SCC cases are curable when caught early. If you notice suspicious skin changes, seek medical attention promptly to ensure the best outcome.

By staying informed and proactive, you can reduce your risk and protect your skin from squamous cell carcinoma.

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